Electronic dental charting

ABSTRACT

Systems, methods, electronic devices and computer-readable media for charting dental information are described. The method includes generating or retrieving a dental data set including separately-modifiable parameters defining dental information relative to a base parametric model, the parameters providing information for generating signals for displaying a three-dimensional (3D) representation of at least a portion of a dentition represented by the dental data set; receiving an input via the 3D representation; and based on the received input, adjusting at least one of the parameters.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. patent application Ser. No.14/258,459, filed Apr. 22, 2014, which claims the benefit of U.S.provisional application 61/816,332 filed Apr. 26, 2013, and entitledELECTRONIC DENTAL CHARTING; the entireties of which are both herebyincorporated by reference.

FIELD OF THE INVENTION

The disclosure relates to the field of dental charting, and moreparticularly to the field of dental charting on an electronic device.

BACKGROUND OF THE INVENTION

Documentation via dental charting has been used for several decades bydental practitioners to help in treatment planning, as well as torepresent a record of the condition of the patient's mouth.Historically, dental charts are created on paper. A typical paper chartshows two-dimensional line drawings of permanent dentition teeth. Theteeth are illustrated in isolation in linear rows with spaces betweeneach tooth to allow room for a dental practitioner to make hand-writtennotes to denote different dental conditions or restorations. A dentalchart can include a periodontal chart having a series of lines to allowhand-written marks designating pocket depth.

Dental charting software development has followed traditionalpaper-based charting and commonly provides a display of a traditionalpaper chart showing linear rows of spaced-apart teeth which can bemarked up by a dental practitioner.

SUMMARY OF THE INVENTION

In various aspects, the present disclosure provides systems, methods,electronic devices and computer-readable media for charting dentalinformation. For example, in accordance with one aspect, the presentdisclosure provides a method for charting dental information. The methodincludes generating or retrieving a dental data set includingseparately-modifiable parameters defining dental information relative toa base parametric model, the parameters providing information forgenerating signals for displaying a three-dimensional (3D)representation of at least a portion of a dentition represented by thedental data set; receiving an input via the 3D representation; and,based on the received input, adjusting at least one of the parameters.

In some aspects, the method includes generating charting text based onat least one charting template associated with a dental activitycorresponding to the input received via the 3D representation.

In accordance with another aspect, the present disclosure provides anelectronic device for charting dental information. The device includesat least one memory; and at least one processor. The at least oneprocessor is configured to: generate or retrieve a dental data setincluding separately-modifiable parameters defining dental informationrelative to a base parametric model, the parameters providinginformation for generating signals for displaying a three-dimensional(3D) representation of at least a portion of a dentition represented bythe dental data set; receive an input via the 3D representation; and,based on the received input, adjust at least one of the parameters.

In accordance with another aspect, the present disclosure providesexample methods and devices wherein portions of a dental chart can benavigated and modified through interaction with a visual representationof the dental chart.

In accordance with another aspect, the present disclosure providesexample methods wherein a single or multiple dental or medical 3D visualcharts can be converted into an independent and standalone format whichstores the information contained therein. The format may contain theinformation in whole, in part, or in condensed form, which may betextual or visual.

BRIEF DESCRIPTION OF THE DRAWINGS

By way of example, reference is now made to the accompanying drawings,in which:

FIG. 1 shows an example system suitable for charting dental information.

FIG. 2 shows an example client or central device.

FIGS. 3-6, and 6A show flowcharts illustrating aspects of an examplemethod for charting dental information.

FIGS. 7A-D, 8-12, 13A-D, 14A-B, 15A-D, 16-21, 23-32, 33A-B, 34-38, and43 to 45 show example visual representations of at least portions of adental chart.

FIG. 22 shows an example view of a display for interacting with anexample system.

FIG. 39 shows an example user interface element.

FIG. 40 shows a flowchart illustrating aspects of an example method forconverting dental information.

FIGS. 41 and 42 show examples of converted dental information.

DETAILED DESCRIPTION

FIG. 1 shows an example system 100 for electronic dental charting. Insome examples, aspects of the system can be used to help a dentalpractitioner to create and maintain a patient dental chart on anelectronic device. Aspects of the example systems can, in some examples,be a component of a larger management information system to assist indental practice management.

For the purposes of this disclosure, the term dental is not limited tothe context of the practice, information, and charting performed bydentists, but can include anything related to one or more aspects of themouth or oral treatment, including but not limited to anything relatedto the practice of dentistry, orthodontics, periodontics, endodontics,prosthodontics, and the like.

In the example shown, system 100 includes one or more client devices 110on which dental charting information can be accessed, displayed, ormodified. In some examples, the client devices 110 can connect to acentral device 120. The central device 120 can, in some examples, be aserver or electronic database for hosting dental charting information,or can include software applications or modules for performing variousaspects of the dental charting system.

For example, a dental office can include several client devices 110 atdifferent locations such as treatment rooms, reception desks, counselingareas, or offices. In some examples, the client devices 110 and centraldevice 120 can be at different locations such as terminals in differentoffices or a server or database hosted at a remote location. Dentalcharting or application information can be communicated between devicesvia network 130. The network 130 can include one or more private and/orpublic networks. The network 130 can include a wired network such as awired local area network or the internet, or wireless networks such ascellular telephone networks or Wi-Fi networks.

While the example system shows three client devices and one centraldevice, any number of client or central devices can be used in anysuitable arrangement.

In some examples, the central device 120 can host or have access to adatabase storing dental charting information. In some examples, thecentral device 120 can provide processing or host an application orsoftware module accessible by a client device for performing variousaspects of the methods described herein.

In some examples, the central device 120 itself may also be a clientdevice 110 on which dental charting information can be accessed,displayed or modified.

In some examples, a single electronic device 110 such as a personalcomputer can be used to store, access, display and modify dentalcharting information.

In some examples, the system can include a database located at a clientdevice 110, a central device 120, or elsewhere on the network. Thedatabase can, in some examples, store dental charting information. Insome examples, local or backup copies of dental charting information canbe stored at a multiple locations including a client device 110, acentral device 120, or elsewhere in the system.

Examples of client 110 and central devices 120 can include, but are notlimited to, computers, servers, tablet or mobile computers, or mobilephones.

FIG. 2 shows an example client 110 or central device 120. The device110, 120 can include one or more processors 210 connected to one or morememories 220, communication modules 230, input devices 240, or displays250. In some examples, a memory 220 can store modules which enable aprocessor 210 to perform any aspect of the methods described herein. Insome examples, a memory 220 can store dental chart information. In someexamples, a memory 220 can store models, images, renderings or othervisual representations of various anatomical structures or dentalappliances.

In some examples, a device 110, 120 can include a communication module230 which may include hardware or software for communicating dentalcharting or application information over network 130.

In some examples, a device 110, 120 can include or be connected to oneor more input devices 240 for receiving inputs to edit dentalinformation or to otherwise operate the device 110. Input devices caninclude keyboards, mice, touchscreens, touchpads, navigation devices,remote controls, tablet computers, mobile phones, or other suitableinput devices.

In some examples, a device 110, 120 can include or be connected to adisplay 250 for displaying aspects of a dental chart.

In some examples, computer-readable instructions such as a computerprogram or application can be installed or otherwise operable on aclient or central device, or can be stored on a non-transitory,computer-readable medium.

In some examples, when dental charting information is stored at acentral device, it can be accessed by different users at differentlocations or on different client devices.

In some examples, one or more devices 110, 120 can be configured torequest, receive and/or verify user credentials to control access todental charting information stored in the system 100. In some examples,user credentials or identifiers may be stored in association withadditions, deletions, or other modifications performed on a dentalcharting information.

In some examples, user credentials may be based on a user account at anoperating system level, a user account in the dental softwareapplication, via a user account in another software application workingin conjunction with the current system, or otherwise. The one or moredevices 110, 120 may be configured receive input signals representinguser credentials for verification before access is granted.

Access may be controlled to the application as a whole, on a dentalpractice basis, on a dental chart by dental chart basis, or in any othermanner.

In some examples, electronic dental charting can reduce or eliminatepaper-based records-keeping and possible inefficiencies of searchingfor, transporting or losing physical records. In some examples, thesystem can be configured to allow for the printing of paper charts.

In some examples, the system can be configured to allow for the creationand storage of electronic backup copies of the dental chartinginformation.

The system 100, in some examples, provides a digital design environmentin which aspects of the system can be used to create and store dentalcharting information based on parametric models.

In some examples, the system can model dental charting information forany dental procedure, including orthodontic, periodontal, endodontic,pedodontic, medical, and oral-surgical procedures.

In some examples, one or more devices 110, 120 and/or one or more oftheir processor(s) 210 can be configured to performed any aspect(s) ofthe methods described herein.

FIGS. 3-6, 6A show flowcharts of example methods 300, 300 a, 300 b, 300c, 300 d of charting dental and/or medical information. These flowchartsshow example operating sequences of example system 100; however, it isto be understood that aspects of different flowcharts can be combined orcan be performed in any suitable order.

At 310, a device can be configured to generate or retrieve a dental dataset. In some examples, the dental data set can be retrieved locally froma memory or another storage connected to the client device 110. In someexamples, the dental data set can be retrieved from a central device 120via network 130.

The dental data set can, in some examples, include a set ofseparately-modifiable parameters which define information regardingaspects of a state of a patient's dentition or mouth. The parameters candefine aspects of one or more objects relative to a base model, forexample, the location, size or orientation of a tooth relative to a basemodel. In some examples, the base model can include a set of rules suchas a three-dimensional coordinate system. In some examples, the basemodel can include one or more two or three-dimensional curvesrepresenting the shape of parts of a dental arch. In some examples, thebase model can include base markers or base tooth positions on thecurve(s). The base model may also include base parameters identifyingbase object models.

The dental data set, in some examples, can include parameters referringto object models of teeth, implements, gums, restorations, fractures orother objects in a patient's mouth. In some examples, these models candefine relative dimensions and boundaries of the object. The models canalso, in some examples, define rules of how the object can be scaled,moved, rotated, be attached or interact with other objects. In someexamples, models can be stored as part of a software package or alibrary on a client or central device. In some examples, the models caninclude default parameter values. The models themselves can be storedseparately from a dental data set and/or the representative parameters.

In some examples, the teeth or other object models can be genericmodels, or can be models based on actual characteristics of a patient'sactual teeth.

In some examples, a dental data set can include parameters identifyingor referencing multiple object models and various adjustable aspects ofthe object. For example, a dental chart can include parametersidentifying or referencing a central incisor tooth. The dental data setcan, in some examples, include additional parameters defining thelocation, orientation or other aspects of the incisor relative to a basemodel. For example, the dental data set can include a parameteridentifying a tooth based on the central incisor object model, andparameters specifying the location of the object on a curve representingthe patient's maxilla dental arch. In some examples, the data set caninclude parameters defining characteristics of one or more object modelsrelated to a base object characteristics. For example, the data set caninclude a size or scaling parameter defining the size of a tooth objectrelative to the base or default size of the tooth object.

The data set can, in some examples, include a collection of parametersor values in a parametric model for defining aspects of a subjectdentition/mouth or other anatomical structure.

By referring to object models such as teeth and dental implements andadjusting parameters based on properties of the object models relativeto a base model or set of rules, a patient's mouth can, in someexamples, be completely represented three dimensionally by a set ofparameters. These parameters can provide information for one or moreprocessors to generate signals for displaying a two or 3-dimensionalvisual representation of at least a portion of a dentition/mouthrepresented by the data set.

An internal record of all user interactions with the 3D model may bestored by a program. When a user performs a modification to the model,such as adding an orthodontic appliance, the program may storeinternally the parameter that represents that state. The informationstored internally may vary depending on the parameter. This may include(i) the object the parameter is applied to (a single “item” in the 3Dmodel, such as a tooth, a bracket, an archwire), and (ii) detailsregarding that parameter (i.e., the template ‘text’ used to representthat object, color, etc.).

For example, if the user marks a tooth as an implant, then one of theparameters stored with every tooth object (whether the tooth is animplant or not) may be modified internally in the program to representthe new state of that object.

In another example, if a user marks a filling on a tooth by using apointing device and selecting the area/surface where the filling will bestored, the program may create parameters representing where thatfilling was marked. In the case of the filling, this could be 3D modelinformation (i.e., UV coordinates) describing how that filling can beshown in future instances when the user opens the treatment card,without having to click and mark the same filling each time.

The collection of all the parameters, in total, that the program has,may be described as the program's “state.” The state may simply describeeverything that the user has inputted into the program to date. This mayinclude brackets, archwires, elastics, springs, fillings, and otherdental appliances and procedures.

With reference to FIG. 4, in some examples, generating/retrieving (block310) a dental data set can include retrieving a template dental data setfor creating (block 314) a new dental chart. In some examples, thetemplate dental data set can include parameters identifying all aspectsof an average mouth. For example, a template dental data set can includeparameters defining a standard set of teeth and parameters defineddefault locations and orientations of those teeth.

In some examples, the template dental data set can be based on a defaultbase model and any parameter can define deviations from this base model.

In other examples, the template dental data set can include parametersdefining default locations and orientations of objects relative to abase model such as a three-dimensional coordinate system or one or morecurves defining the shape of a dental arch.

In some examples, the system can include different template dental datasets or base models on which a patient's dental data set can be based.For example, there can be different template data sets or base modelsfor primary dentitions (baby teeth) or permanent dentitions (adultteeth). In some examples, the system can have different template datasets or base models which incorporate the different mouth or toothshapes common to different populations.

When multiple template data sets or base models are available, in someexamples, a device can optionally receive (block 312) an input to selectthe template data set or base model from which a new dental data set isto be created.

In order for software to generate text notes, it may compare at leasttwo separate model states. Typically, this may result from having atleast two different patient visits, which may have some parameters whichdiffer. For example, the orthodontist may have switched out one of thearchwires.

The software may analyze the at least two separate states, taken from atleast two different visits, and may compare them, parameter byparameter, to determine the differences between the at least two visits.The program may convert these differences into a text format. Forexample, say that on a particular visit, the orthodontist used a wire“a” and the next visit switched to a wire “b”. The program may analyzeboth visits, see this difference, and create a text statement of apredefined format. For example the program may make a notation such as“changed upper archwire from a to b.”

Each different parameter may be converted to a text statement. Theparameters may differ depending on the object and its relevantinformation. For example, when an elastic is added, the attachmentpoints it connects to may be stored, along with the elastic type andduration. Periodontal measurements may take the form of six measurementsper tooth.

Once the program has gone through all parameters and created thestatements, it may combine them into one body of text, and may appendheader and footer information. The header information may include thedate of the visit (the latest of the at least two visits beingcompared), patient name, etc. The description of the parameters, alongwith the header/footer, can form documentation that can be usedindependently of the program. The documentation can describe allrelevant information that was input into the system.

This operation of comparing at least two visits for parametricdifferences can happen on any number of occasions. It may be triggeredas soon as a user inputs one change into a visit. The program maydetermine which visits to compare (the previous visit if there is one,and a base-model if there is no previous visit), and may automaticallygenerate the text description.

In some cases, an existing visit may be reopened and modified. In thiscase, the program may compare the latest parameters of the existingvisit with the previous model of that visit to determine the changes theuser made during that visit.

At 316 (FIGS. 5, 6, 6A), one or more processors can be configured forgenerating signals for displaying, on a display, a visual representationof at least a portion of a dentition represented by the dental data set.In some examples, this visual representation can be updated in real- ornear real-time as changes are made to a dental data set and theunderlying parameters.

In some examples, displaying the visual representation can includedisplaying visual representations of objects in a dentition. In someexamples, the objects, such as teeth or implements, can be displayedbased on the associated parameters in the dental data set. In someexamples, the visual representations can include dental conditions,restorations or dental appliances on one or more teeth based on theparameters of the dental data set.

Parameters in the data set can, in some examples, provide informationfor identifying objects, renderings, images, pre-images or other datafor displaying a 3D representation of one or more teeth, appliances,conditions, or other aspects of a mouth or dentition. For example,parameters can identify a specific visual model of a tooth, implant, orother object which can be used to generate signals for displaying a 3Drepresentation of part of all of the subject dentition/mouth.

At 320 (FIGS. 3-6, 6A), a client device receives an input to edit dentalinformation. In some examples, the input can be received when a keyboardinput, such as a shortcut key or an entered data value, is received,when a menu option is selected, or in any other manner. In someexamples, an input can be received through an interaction with or via animage or visual representation of at least a portion of the dental dataset. For example, a user can click and/or drag a cursor, providekeyboard inputs, or touch and swipe a touchscreen, over a tooth toadjust its position or orientation. In some examples, an input to editdental information can include any one or combination of clicks,gestures, keyboard or shortcut inputs. In some examples, an input caninclude audio commands.

Receiving an input to edit dental information with or via a visualrepresentation may, in some examples, include receiving an input via aslider, selection box/list or other parametric adjustment interfaceelement.

At 330, 330 a parameters included in the dental data set can be adjustedbased on the received input. In some examples, by iteratively receivinginputs and adjusting parameters, a dental data set can be updated todocument the state of a patient's mouth/dentition.

In some examples, at 335, one or more processors can be configured togenerate charting text. While illustrated, for example, in FIGS. 3, 4,5, and 6A as occurring after the adjustment of parameters, thegeneration of charting text can also be configured to occur before orconcurrently with the adjustment of parameters.

One or more processors may be configured to generate charting text basedon the activity associated with the received input. For example, if aninput received with/via the 3D representation indicates that an area oftooth decay is to be added to a particular incisor, the one or moreprocessors may be configured to generate a charting entry of “Cariesdetected on buccal face of 21”.

In some examples, the one or more processors may be configured toautomatically generate charting text based on template(s) or definedphrases/terminology. These template(s) may be based on standard orgenerally accepted dental/medical notation/terminology, or in someexamples, may be customized based on a practitioner's preference.

As noted in the example above, in some instances, the generated chartingtext may be less specific than the actual information in the data set.For example, while an area of tooth decay may be specifically defined byway of one or more parameters in the data set in terms of location,size, depth, etc., the generated charting text may only indicate thatthe caries is detected on a particular face of a particular tooth. Insome instances, this may provide simpler, charting information withoutextraneous details.

In some examples, the one or more processors may be configured to onlygenerate charting text for certain types of inputs. For example, a viewchange input may not generate charting text.

In some examples, the generating the charting text may includegenerating text, activity codes, etc. for billing or insurance purposes.

In some of the described example embodiments, the automatic generationof charting text corresponding to an input received via the visualrepresentation may eliminate or reduce the need for a user to manuallyinput charting text. In some examples, this may reduce the time burdenon a user.

In some examples, the automatic generation of charting text may reduceerrors or charting inconsistencies through its use of standardizedlanguage. In some examples, the automatic generation and display ofcharting text alongside the 3D visualization may provide a visualdouble-check for a user to verify that the proper dental activity hasbeen inputted.

Other non-exhaustive examples of generated charting text appear in FIG.41.

In some examples, once a dental or medical data set is received by theprogram, one or more processors may create and configure an internalbinary state of the program, which either allows (editable) or disallows(lock) modifications of the data set as a whole. This locked state mayallow all changes to the view to be performed as defined herein orotherwise as well as traversal between data sets, but may not allow anychanges of information attached to the data set, parametric orotherwise. This status may be determined by the ‘age’ of the data set,the time since the initial creation of that data set, as well as thecurrent authenticated user, or other mechanisms. Additional internalbinary states controlling modifications may also exist which apply tosections or parts of the data set (specific sets of parametric or otherinformation), and may be determined by mechanisms described herein orotherwise.

With reference to FIGS. 6, 6A, in some examples, a device can receive360 a view change input. In some examples, this can include a keyboardcommand, a menu selection, or interaction with the visualrepresentation. The view change input can represent a request to changea view of the displayed visual representation. Changes to the view caninclude but are not limited to: repositioning a camera view, zoomingin/out, opening or closing the mouth, unfolding the arch, spacing outthe dental arches and teeth contained therein, or centering the view ona particular object. FIG. 24 shows example visual representations usinga default view, a view after a camera rotation, a zoomed in view, and aview with the mouth open. All changes in view can maintain informationcontained in the dental arches, using parameters or otherwise, such asattached devices, markings, or objects that create an interconnectionsbetween other objects, such as elastics, springs, or c-chains.

In some examples, displaying a 3D visual representation from adjustableviews can show restorations which extend beyond a single side of atooth, or the operation of mechanisms such as (but not limited to)elastics or springs.

By providing a visual representation which can be interacted with toprovide an input, the system, in some examples, can provide auser-friendly or intuitive interface for navigating or modifying adental data set.

In some examples, the view of the visual representation or simulationcan be manipulated through direct simulation interaction when a viewchange input is received 360. For example, functions can includemanipulating the view in the horizontal plane and manipulating the viewin the vertical plane. The horizontal view manipulation can be performedby interacting with the input device in the horizontal direction (suchas a click-and-drag with a computer mouse, or a hold-and-drag with atablet pen or finger), causing the simulation to rotate. The rotationcan be computed using a linear translation between the amount of pixelsthe input device moves in the horizontal direction and the angle ofrotation. For example, FIG. 25 shows different views as a visualrepresentation is manipulated through direct simulation interactionwherein the input is a horizontal view manipulation. The vertical viewmanipulation can be determined in a similar way by using the inputdevice along the vertical axis. For example, FIG. 26 shows differentviews as a visual representation is manipulated through directsimulation interaction wherein the input is a vertical viewmanipulation. In some examples, the views can be redisplayed in real orsubstantially real-time as a user continues to hold-and-drag the input.

The auxiliary functions for interacting with the view can includezooming, opening/closing the dental arches, and centering the view on aparticular object. In some examples, these can be performed using anauxiliary slider provided as part of the graphical user interface of theprogram, as well as auxiliary functions attached to the input device(such as using the mouse scroll-wheel). For example, FIG. 27 showsdifferent views as a visual representation is manipulated wherein theinput is a zoom input.

FIGS. 33A and 33B illustrate an example of centering a view on aparticular object, wherein an interaction with tooth 3310 in the initialview shown in FIG. 33A causes the view to change to center on the tooth3310 as shown in FIG. 33B.

In some examples, the opening or closing of the dental arches can alsobe controlled via an auxiliary slider, and can perform two separaterotations, one on the maxillary and one on the mandible. Based on theparametrics or otherwise, information for the dental arches, includingattached devices and markings, can remain fixed to the dental arches(see for example, FIG. 28). The rotation can be performed about a pointlocated behind the dental arches in space, such that when the arches areopened, the visual representation can show the inside surfaces of thearches (see FIG. 29). In some examples, responding to input to open orclose the dental arches can provide a simulation of how the jaws of thedental data set interact or move relative to one another.

In some examples, the teeth which lie on the arches can be transformed,using a systematic combination of translations and rotations, such thata more desirable view of all individual objects in the data set isattained. This may include a ‘folding’ operation, where the teeth of thearches are transformed until they lie along a straight line, and thebuccal or lingual side of each tooth in the arch is visible withoutfurther view manipulation. This transformation may be appliedincrementally through interaction with the view, for example, throughthe use of an auxiliary slider, which can be modified using inputmethods as described above, as well as inversely. For example, FIG. 34shows progressive views of a folding/unfolding operation. As the slider3410 is adjusted, the objects in the view are progressivelyfolded/unfolded.

In other examples, interaction with the visual representation orotherwise can cause a variable amount of space to be added between theteeth of the visual representation, such that the mesial or distal sidesof the teeth can more easily be viewed or marked. For example, FIG. 35shows this operation applied to the folded and unfolded dental arches.The operation may have two parameters, which may be adjusted by theuser: the equidistance created between each tooth within an arch, andthe distance created between the arches.

In some examples, upon receipt of a view change input, one or moreprocessors can be configured to edit view parameters in the dental dataset. These parameters may include but are not limited to one or morefold parameters, spacing parameters, angle parameters, and zoomparameters.

In addition to changing the view of a visual representation of a dentaldata set, inputs to edit dental information can be received 320 viadirect interaction with the visual representation, or by other means. Insome examples, this can result in real or near-real time editing 330 a,330 of dental data set information by way of adjusting parameters orotherwise. In some examples, as an input is dragged, the visualrepresentation can be updated to reflect the changing dentalinformation. In some examples, as an input is dragged, the visualrepresentation can reflect a proposed change in the dental informationuntil the click-and-drag or hold-and-drag is released, at which pointthe change to the dental data set can be performed.

In addition to the above, additional examples of receiving inputs,adjusting parameters and generating dental charting information aredescribed for various example dental objects below.

In some examples, a client device can receive an input when a userselects one option from a set of parametric options. For example, a usercan document incorrect tooth alignment (a malocclusion) by moving anytooth away from an initial location. In some examples, the initiallocation can be a default, template or previously defined location. Theamount and granularity of displacements can, in some examples, belimited by the system. For example, a system may permit toothtranslations in 0.1 or more mm increments, or may limit a maximum toothdisplacement from an initial location in any one direction to 1 cm. Insome examples, the system can include parameters to identify up to 3object translations. The translations can, in some examples, beparametrically defined along the axes of the tooth: the mesial-distal,apical-coronal, and buccal-lingual axes. In some examples, parameterscan identify object rotations. In some examples these rotations may bedefined with respect to the same three axes of a tooth. In someexamples, the rotation parameters can also be limited in terms of theirgranularity (for example, 2.5° increments) or their maximum rotationfrom a default value (for, example up to 15°).

In some examples, translations or rotations can be applied singly, or incombination to a single tooth thereby adjusting one or more parameters.FIGS. 7A and 7B illustrate example before and after visualrepresentations of a tooth 810 before and after a single-dimensionaltranslation. FIGS. 7C and 7D illustrate example before and after visualrepresentations of a tooth 810 before and after a single-dimensionalrotation. In some examples, multiple translations and/or rotations canbe effected by a single input. For example, a tooth can be translated intwo dimensions with a single dragging motion.

In some examples, an input to edit dental information can affectparameters of a single object as seen for example in FIGS. 7A-D. In someexamples, an input to edit dental information can affect parameters formultiple objects.

For example, as illustrated in the example visual representation of adental data set in FIG. 8, a mesial-distal translation can create aspace of open contact 820 between teeth. In one example, this space canbe defined by the explicit selection of all three upper molars 830 a,830 b, 830 c and receipt of an input to move the selected teeth. In thisexample, transformations can be applied to multiple objects.

In another example, the space of open contact 820 can be defined when aninput is received to move the single first molar 830 a distally. Basedon collision detection, the second 830 b and third 830 c molars can havetheir location parameters adjusted in conjunction with the locationparameters of the first molar 830 a.

In some examples, collision detection can be configured to restrict themovement of an object if it would cause a collision or overlap with aneighboring object.

In some examples, when creating malocclusions, real-time collisiondetection can align teeth in the model according to their physicalconstraints, such that no unintended gaps or tooth overlaps appear inthe model.

In some examples, a received input can result in the adjustment of theparameters of multiple objects or of parameters related to the dentaldata set as a whole. For example, when a dental data set is firstcreated or after it has already been modified, the initial template usedas the base model for the simulation can be modified to better match thepatient's dentition. For example, adjustments can be made to the widthof the dental arch, the size of the jaw, or the curve of spee (avertical curvature of the dental arch). In some examples, thesemodifications can be restricted to a finite set of options. For example,the dental arch can be made wider or narrower, and in some examples canbe limited to options between 70% and 130% of the default dental archwidth, in 5% increments. In another example, the jaw can be made smalleror larger, and in some examples can be limited to options 70% and 130%of the default dental arch size, in 5% increments. In some examples,differences in jaw size can be displayed as a difference in the size ofall the teeth of the dental arch. In another examples, the curve of speecan be set in millimeters, and in some examples can be limited from −5mm (a downward curvature) to +5 mm (an upward curvature), in 1 mmincrements.

Examples of these modifications are illustrated in FIGS. 13A-D whereinFIG. 13A shows an example default or template visual representation of adental data set, FIG. 13B shows an example visual representation of ajaw with a 15% size increase, FIG. 13C shows an example visualrepresentation of an arch with a 15% smaller width, and FIG. 13D shows avisual representation of an arch with +3 mm curve of spee.

The system, in some examples, can provide other parametric options, suchas tooth removal (see, for example, FIG. 9).

In some examples, a dental data set and the associated parameters candesignate the presence of a dental veneer or crown, as well as otherconditions (see FIG. 10). In some examples, these parameters can berepresented in a visual representation by different colors. The colors,in some examples, can be customized so that a dental office or user mayuse their own colors to designate what they deem important, and newcolors and presets may be added if required.

In some examples, parameters can be adjusted to replace individual teethwith an implant (see, for example, FIG. 11).

In another example, parameters can be adjusted such that threeconsecutive teeth which have not been removed can be replaced with adental bridge. FIG. 12 illustrates two views showing an example of adental bridge applied to the upper canine.

Parameters or parametric options described herein can be applied to anyindividual tooth or to any combination of teeth. In some examples, auser can cycle over each tooth the user wishes to modify, select it, andselect the appropriate option (such as to change the tooth to animplant, to remove it, or to color-code it). Upon receiving this input,the device can adjust (add, modify, or remove) the appropriateparameters.

Other example parametric options can include adding and selectingorthodontic wires, brackets, elastics, springs, c-chains, or otherimplements. Upon receiving an input to add or modify an object such as,for example, an implement, appliance, tooth, periodontal anatomy, dentalcondition, or restoration, parameters in the dental data set can beadjusted by creating or modifying parameters corresponding to objectmodels or parameters associated with those objects.

For wires such as orthodontic wires, a user can select, for example,different wire thicknesses, rectangular, round, or other cross-sections,different materials, and other wire parameters. In some examples, theparametric sets for these objects are not fixed and can be customizable,for example, to the types of wires or brackets used by a particulardental office.

In some examples, a wire can be displayed based on the wire object'sparameters. For example, FIG. 14A shows an example visual representationhaving rectangular wires, and FIG. 14B shows an example visualrepresentation having round wires. The wire object's parameters may alsoinclude parameters which describe the existence of wire bends, includingtheir location and effect on the wire. The bend may be located on a wiresegment between any two adjacent brackets. The effect of the bend may bea translative effect, where the teeth affected by the bend are movedalong any one of or a combination of the mesial/distal or buccal/lingualaxes relative to their base positions. The effect may also be arotation, creating a ‘tip’ or the tooth or teeth affected, such astoward or away from the mesial, along the wire, where the tooth tipsalong or away from the lingual, or a rotation along the long axis of thetooth. The bends may be applied to a single tooth or to multiple, as asingle bend or as combinations. For example, FIG. 36 shows bends 3610applied to several teeth of the upper arch. The displacement distancecreated by the bends may be 1 mm by default, and can be modified by theuser. Wire parameters may also include archwire stops 3710 and archwirehooks 3720 as in FIG. 37, as well as the location of the wire, buccal orlingual.

In some examples, a wire can be added to each dental arch, the maxillaand mandible, separately. Color-coding can be used for wires, to allowthe operator to distinguish the material and type of wire. In someexamples, the colors available, and the type of wire they correspond to,may be customized. In some examples, by default, the wire extends to thefurthest brackets that have been applied to each dental arch, but thismay be modified by the operator.

In another example, selecting between different types of brackets willrender them in different colors, according to the customizablepreferences available. In some examples, this color-coding can helpdental assistants differentiate between different brackets, such as thetype (for example, brand and model) or torque rating of the bracket.FIGS. 15A-D illustrate example visual representations.

In some examples, brackets can be applied to the entire dental arch as asingle input preset (such as a standard bracket type applied to theincisors, canines, and first and second molars), or they can be appliedselectively to each tooth as required.

In some examples, brackets can be applied to one or multiple selectedteeth using a single input.

In some examples, orthodontic elastics can be added to the dental dataset. In order to add elastics, the user can activate an ‘add elastic’function from a menu, and can select elastic attachment objects in thesequence in which the elastic connection is to be applied. The selectioncan be received from an input device such as a direct interaction with a3D object in the visual representation. In some examples, an elastic mayonly be attached to specific types of objects such as orthodonticbrackets, orthodontic bracket hooks, wire hooks, and lingual buttons.FIG. 30 shows examples of elastics attached to different types ofobjects. In another example, wire connections can be similarly inputtedthrough sequential selection of attachment objects.

In some examples, the system can render a visual representationincluding connections between the elastic attachment objects by drawingan outline around the attachment object, and drawing a straight linebetween the center points of each two consecutive attachment objects(see, for example, FIG. 31). The color of the elastic outlines and linesand textures can be modified by the user and stored as a preference, torepresent different types of elastics (such as full-time or night-time,or different types of materials). Opening or closing the dental arch canmaintain the connections between the attachment objects to simulate a‘stretch’ of the elastic (see, for example, FIG. 32).

Elastics can, in some examples, be added by having the operator selectthe attachment objects in order, followed by a termination signal whichtriggers the input. Attachment objects for elastics can include forexample, brackets, bracket hooks, wire hooks, temporary anchoragedevices and lingual buttons. In some examples, the order in which theoperator selects the attachment objects can determine how they areconnected with the elastic.

In one example, the operator can pick the attachment objects using aleft-click of the mouse, followed by a right-click to designate the endof the sequence. In some examples, the system can differentiate betweendifferent elastics, such as full-time or night-time elastics, as well asthe material. One or more elastics can be applied, and in some examples,they may connect attachment objects that are located on the same dentalarch, or on opposing dental arches. When attachment objects of opposingdental arches are connected, the visual representation can, in someexamples, show the elastic stretch as the dental arch is opened orclosed. Examples of visual representations of different elasticconfigurations are illustrated in FIG. 16.

In some examples, elastics may be added by using preconfiguredtemplates. These templates may include the duration and material of theelastic, as well as the configuration of the elastic, defining theattachment objects and their order. These templates may includeconfigurations which are commonly used in the orthodontic profession,such as Class II, Class III, triangle, or other, and may be customized.In some examples, the user may add the template without needing tospecifically identify the material and attachment objects of theelastic, but which may be modified after the fact.

In some examples, other types of objects which create aninterconnectedness between attachment objects may be added, such assprings and c-chains. These objects may be attached to specific markingpoints of other objects, including archwire hooks, bracket hooks,bracket bodies, lingual buttons, and temporary anchorage devices. Forexample, FIG. 38 shows some of these objects. C-chains may includeparameters which specify whether they are open or closed, and whenattached to bracket bodies, may be over or under the wire.

In another example, lingual buttons and bite turbos can be added to anysingle tooth, or any combination of teeth. Example bite turbos andlingual buttons are illustrated in the example visual representations ofFIG. 17.

In some examples, springs may be added to any wire segment (a ‘piece’ ofwire that is located between any two adjacent brackets). Applied springscan, in some examples, be designated as closed springs or open springs,and can be added to one or more wire segments. Any wire segment can beused. In some examples, an archwire stop may also be added to any wiresegment.

In some examples, a user can interact directly with a visualrepresentation such as a 3D object. In some examples, direct modelinteraction can be used as an input to select a location for a marker orto select an area. Selected objects, or locations or areas of a selectedobject can, in some examples, be used to define a location of arestoration (dental filling) or crown, or a tooth condition such as acavity, calculus or discoloration. Upon receiving an associated editinput, parameters can be created or modified to define the selected areaand the type of restoration or crown.

In some examples, inputted markers can be used to create a smoothedoutline which can be filled in with a color or texture.

When a visual representation of the dental data set is displayed, theparameters can, in some examples, to render a surface or portion of atooth including the restoration. FIG. 18 shows example visualrepresentations wherein an area is selected and highlighted. In someexamples, restorations or oral conditions can be displayed havingdifferent textures, or colors. In some examples, different colors can beused to represent a type of restoration, such as a composite resin,amalgam, porcelain, gold, or glass ionomer cement. In some examples, thecolors and their corresponding material may be customized, such that acolor for a particular material can be modified, and new colors andmaterials may be added.

These restorations may also be added to an object by use of templateswhich define, using standardized dental terminology, the location of therestoration, whereby the program stores the location of the markers usedto show the area representing the restoration internally. These mayinclude Class I, Class II, Class III, Class IV, Class V, or class VIrestorations as commonly understood by dentists. When a user adds arestoration by this method to a specific tooth, they may only berequired to input the material which the restoration is composed of.

In some examples, color-coded regions of the tooth may also represent adental condition, such as plaque, tooth decay, calculus, orperiodontitis. A dental practitioner may, for example, create a regionon a tooth of a particular color, and add a note to it, and in someexamples can allow flexibility in interpretation. FIG. 19 shows examplevisual representations of teeth for identifying different conditions orrestorations. These parameters can be applied to any number of teeth ineither dental arch. Parameters can be applied to more than one tooth,when the operator, for example, provides corresponding inputs at eachtooth separately to creating the mark on the tooth. In some examples,more than one region may be selected on any individual tooth. In someexamples, when there is an overlap between selected regions, the systemcan uses digital compositing to combine the colors of the differentregions.

In some examples, a similar procedure can be used to provide an input toadjust parameters for the gum model, to mark a region, for example,denoting the condition of gingivitis.

In some examples, inputs such as direct model interaction can also beused to select a location for a temporary anchorage device on the bonemodel. The operator can, for example, click on any location of the 3dmodel to mark where a temporary anchorage device should be shown on thedata set. Any number of temporary anchorage devices can be applied toone or both dental arches. FIG. 20 shows example visual representationsof a dental data set including temporary anchorage devices.

Similarly to the gum model, in some examples, a region of the bone modelmay be selected, for example to mark bone loss, or any other condition,as determined by the adjusted parameter and corresponding colorassociated with the parameter value.

In some examples, any number of the parametric and 3d model interactionmodifications discussed herein can be applied in combinations, such thatmany possible dental or medical 3D visual data sets can be created. Insome examples, applied parametric changes may be reversed, by selectingthe opposing option, or removing the respective mechanism or mark fromthe dental or medical 3D visual data set or with an undo button. Forexample, a complicated dental data set may include severalmalocclusions, tooth removals, implants, brackets, wires, elastics, andsprings (among the other modifications discussed), and each may beremoved, modified or reversed, as the course of the patient's treatmentprogresses.

In some examples, a dental data set can be stored automatically withevery parameter adjustment or at preset intervals, or manually whenrequested by a user. At block 340, a dental data set including all theadjusted parameters can be stored at a client or central device in anelectronic database or otherwise. For greater clarify, storage of thedental data set can, in some examples, include storingautomatically-generated or manually-entered charting text.

After creating and storing the dental data set the first time,subsequent times when the dental practitioner requires access to thedental data set, it can be retrieved from the electronic database.Additional modifications to the model can also be stored in theelectronic database for later retrieval. In some examples, documentingthe progress of a treatment or series of treatments can be managed bycreating multiple dental data sets at different times. In some examples,a complete history of all parametric changes can be stored. In someexamples, a user can retrieve previous dental data sets as required, tomake comparisons or to aid in patient communications. The defaultretrieval of a dental data set can, in some examples, retrieve the mostrecent dental data set. In some examples, each dental data set or stagesof the dental data set can be stored along with the date and time atwhich the data set was created or modified. In some examples, the dentaldata set can be link to or can include patient information.

In some examples, one or more processors may be configured to generateone or more snapshots of a patient's history by generating signals fordisplaying or printing one or more 3D visualizations of the data set ata specific time. These visualization(s) can be displayed or printedalongside at least a portion of the charting text associated with thedata set at that time.

In some examples, a user can traverse among several related dental ormedical data sets, such as ones created for one patient at differenttimes of the treatment, using a simplified user interface element wherea representative piece of information for each data set is shown in acollection, and the data sets are ordered chronologically. Therepresentative information may include the number of the data set (e.g.starting at number one for the first data set created), or the date.Navigating among the data sets may be performed using this userinterface element, and when the navigation is performed, the other partsof the program, including the menu system and the 3d module, may beupdated with the information contained in the chosen dental or medical3D visual data set. The user interface element shows the current workingdata set, as well as some information associated with the currentworking data set, such as the creation time and date, the number of thedata set, and the edit/lock status of the data set. The program may, insome implementations, prevent further modification of data sets thatexceed a certain age, where age is defined as the time which aparticular data set has existed since it was first created. In the casethat a data set's age exceeds a predefined limit, such as 24 hours, thedata set may have an edit/lock status of ‘locked’ and furthermodifications will not be allowed. If the data set's age is under thepredefined limit, the edit/lock status of the data set may be‘editable’, and the user will be allowed to make further modificationsto the data set as required. FIG. 39 illustrates an example structure ofsuch an interface element.

In some examples, a single or multiple dental or medical data sets maybe converted into an independent, standalone format by the program asshown in FIG. 40. This conversion may take all, some, or a condensedform of the information contained in the data set(s), parametric andotherwise, and transform it to an alternative textual or visualrepresentation. In some implementations, this conversion may take eachdata set individually and extract information which shows thedifferences of that data set in comparison to the base model, such asall objects added or removed, all markings created, and all notesattached to the data set or to data set objects. In otherimplementations, the program may take a series of data sets, and convertthem to information which represents the change or modification of eachdata set in comparison to the data set created previously in thechronological sense. For the first data set, for which there is nochronologically previous data set, the modifications are reportedrelative to the base model. The output of this conversion may behuman-readable text, which may be a documentation of the patienttreatment, and may contain associated information, such as the dates andtimes of all data sets, their contents, and their edit/lock status. Thistext may be in a plain-text format (ASCII), or it may be in aformatted-text format. The conversion may create a file of a proprietaryor an open format directly (such as a Microsoft Word file), or it mayopen an instance of a proprietary software, such as one used forword-editing, and fill the document with the output of the conversion.FIG. 41 shows an example of an output that is a formatted documentcreated automatically using the Microsoft Word automation interface. Theoutput file may, depending on the format and capability of theproprietary format, be marked as a ‘final revision’ or with ‘restrictediting’, preventing the user from making any modifications to the file.

In some examples, the conversion of the data set into an alternateformat may be initiated by the user, and in others, it may be automatic,creating and storing a human-readable record of the user actions. Asdescribed herein, this may occur as each user action occurs, after adental or medical 3D visual data set is created and altered, or at thetime the program is closed. This record may be stored on the localmachine 110 or on a remote machine 120 as in FIG. 1. The information maybe communicated to a subsystem of the program, or it may be communicatedto another software working together with the program.

In other examples, the conversion may create an output that is of avisual format, such as a format used for representing 2D or 3D computergraphics. FIG. 42 shows an example of a data set exported to the X3Dfile format, and viewed in an independent viewer FreeWRL. The data maybe exported in a 2D format as an image, such as a png or jpeg. In theseexamples, the output is a ‘snapshot’ of the data set, and can no longerbe modified by adjusting parameters or otherwise. These files can bedistributed and stored independently of the program and the originaldata set used to create them.

In some examples, the system can store the dental data set in a textformat such as Extensible Markup Language (XML). In some examples,dental data sets can be stored in an electronic database and can beaccessed for example via structured query language (SQL).

In some examples, the dental data set can be primarily parametricinformation such as parameters and values. By not including model orimage information, some example dental data sets can be compact in size,and can, in some examples, be more efficient to store, backup, access ortransfer.

At block 316, in some examples, a visual representation of a portion ofa dental data set can be displayed in 3-dimensional form as illustratedfor example in FIGS. 7A-D, 8-12, 13A-D, 14A-B, 15A-D, and 16-21. In someexamples, the system can use a software or hardware 3D accelerator todisplay the 3D representation. In some examples, a 3D model can allowsthe user to see the mouth model in perspective view wherein objectscloser to the camera appear bigger. Photorealistic or non-photorealisticrendering techniques can be used individually or combined.Photorealistic techniques can, in some examples, include color-shadingthe models to simulate light-reflection, or using life-like textures andbump maps. Non-photorealistic techniques can, in some examples includerendering orthodontic brackets and wires or using color-coding. In someexamples, these techniques can make it easier for the office staff todifferentiate between different mechanisms used.

In some examples, 3D representations can provide information regardingthe positioning of a dental arch, or regarding areas of contact betweenteeth. In some examples, this visual representation of dental archpositioning or areas of contact between teeth may not be available usingtraditional dental charting techniques.

In addition to the 3D module (described above), in some examples, thedisplay can contains an area of the screen used for a menu system (see,for example FIG. 22).

In some examples, the menu system can be displayed in a dedicated areaof the program screen, or, in some examples, it may be brought on-screenby an input (a pop-up menu). In some examples, both the menu system andthe visual representation can be used to provide inputs for adjustingparameters in a dental data set.

In some examples, the dental data set can include the dental arches ofthe maxilla or mandible. In some examples, the dental data set caninclude models for the surrounding bone and gums (see, for example, FIG.23).

In some examples, parameters can include periodontal measurements whichcan be used to show a corresponding boundary of the periodontal ligamenton each tooth. In some examples, periodontal measurements can beinputted as 6 length measurements representing periodontal pocket depthat certain locations on the surrounding sides of the tooth. In someexamples, a boundary of the periodontal ligament can be displayed as acolor-coded line, mark, or area on the model of each tooth. Theperiodontal measurements can be relative to a base curve that runsaround each tooth and represents where bone tissue begins on an averagetooth, as seen in FIG. 43. The measurements may occur along 6 imaginarylines, for which markings are stored internally in the software,starting at the base curve. A given periodontal measurement can bemeasured along its corresponding line, along the surface of the tooth.An example of these lines is shown in FIG. 44. In some examples, theselines may not be straight and may conform to the surface of the tooth.The boundary of the periodontal ligament can be determined using the sixmeasurements, which are then connected by the program to yield a smoothcurve. The parameters may be defined in terms of their granularity (in 1mm increments), and a maximum value (such as 6 mm). In oneimplementation, a user may interact with the periodontal line directlyby dragging one of the six markers up or down the marking line (whichmay be shown explicitly with tick marks representing 1 mm distances).

In some examples, the system can operate in substantially real-time,such that it takes minimal time for parameters to be adjusted and anupdate 3D visual representation to be displayed when an edit input isreceived.

In some examples, when displaying a visual representation, a device cancreate a 3-dimensional representation matching the parametric options.This can, in some examples, include all 3D object data required torender the dental data set onto an output device. These objects caninclude matrices of polygon vertex locations, normals, texturecoordinates, and the like.

The 3D object data can, in some examples be rendered using a 3Daccelerator to creates a 2-dimensional image, capable of beingtransmitted to an output device (a display, such as a television orcomputer screen). The result can be shown on the output device and insome examples, can provide visual feedback of changes made to the dentaldata set.

In some examples, system can include internal rules by which it canperform the rendering of a visual representation or simulation. Theserules can, in some examples, make the interaction of the 3D objects inthe visual representation approximate a patient's mouth, simplify theamount of user input required to make simulation changes, or limit thediscretion of the user. Examples of these rules are described herein.

In one example, when a dental arch (maxillary or mandible) is adjusted,it can be refitted by the program. The adjustments can include, forexample: an addition or modification of a malocclusion (such as amovement or rotation of a tooth with respect to its default position inthe arch), a modification in the size of a tooth, the addition orremoval of a gap between teeth, addition or removal of a tooth model,replacement of a tooth model with an implant or bridge, or the additionof a wire bend. In some examples, the refitting process can includerules to ensure that the dental arch appears correctly (withoutinadvertent overlaps in the 3d models). The refitting process can, insome examples, position the teeth models in pairs, starting at theincisors and working towards the molars, along a smooth curve whichrepresents the dental arch. In some examples, for each pair, one toothcan be moved along the arch, starting at the distal end and progressingtowards the mesial end, and the other remains stationary, until aposition is found where the proper contact between the teeth isestablished, using a collision detection algorithm. In some examples, inthe case of a gap, the contact position can be initially established,and the tooth can be moved back towards the distal end of the arch tocreate a gap of the appropriate distance.

In some examples, malocclusion options, such as the apical-coronalmovement, the buccal-lingual movement, the mesial-distal rotation, theapical-coronal rotation, and the buccal-lingual rotation, can beperformed using a series of markers attached to each tooth model. Forexample, the apical-coronal movement can approximate a movement alongthe root-crown axis of the tooth, to reflect different teeth (such asthe incisors versus the molars) having a different ‘tilt’ with respectto the dental arch. In another example, the buccal-lingual movement canbe performed by moving the tooth in a direction that is normal (90degrees) to the arch on which it is placed. The mesial-distal rotationcan be performed about an axis that is normal to the arch. Theapical-coronal rotation can be performed about an axis passing throughthe root-crown axis of the tooth, and the buccal-lingual rotation can beperformed about an axis that is parallel to the tangent of the arch,passing through a marker representing the wire.

In some examples, after the dental arch is positioned, the orthodonticbrackets (if added by the user) can be positioned at a pre-determinedlocation on the surface of each tooth. In some examples, this can ensurethat each bracket is shown by default on an appropriate location on theoutside of the arch, allowing wire segments connecting the brackets tobe more easily rendered. In some examples, the default bracket positionscan be modified by moving them in 0.5 mm increments (from −4 mm to +4mm) along the mesial-distal axis of the tooth, along the apical-coronalaxis of the tooth, or rotating them about the buccal-lingual axis ofeach tooth (in 2.5 degree increments, from −15 to +15). In someexamples, these movements can be performed using 3d markers attached toeach tooth, such that each movement is a rotation around the tooth,approximating the round surface of each tooth using a circle. Therotation can, in some examples, be performed about the wire marker ofthe bracket. Lingual buttons and bite turbos can be positioned similarlyto the brackets by using a pre-determined location on the surface ofeach tooth.

When rendering orthodontic wires, the system can, in some examples, usetwo 3d markers attached to each bracket (one on each side), such that,no matter how the teeth and brackets have been placed, the wire canalways attach to the same location on the bracket. For each wire segment(a piece of wire rendered between each two consecutive orthodonticbrackets), the system can use the bracket markers to create a smoothcurve, and can approximate the bend that is created in the wire by thewire slot of each bracket. Wire springs can be rendered using the samecurve, such that they appear to ‘wrap’ the wire segment to which theyhave been added. Wire hooks can be similarly positioned along thiscurve, and can use the tangent and normal to this curve to positionthemselves along the wire. See FIG. 45 for an example.

In some examples, each bracket, wire hook, bracket hook, temporaryanchorage device and lingual button, can have internal 3d markers forelastic connections, which can be used to show an approximate ‘wrapping’of an elastic that has been connected to it and other objects.

In some examples, the dental data set can be linked to an x-ray, imageor other information regarding a patient's dentition.

In some examples, information that is input to the system may benon-parametric, such as of a textual or auditory format. The program mayaccept such information, and create an internal connection between suchinformation and an object of the dental or medical 3D visual data set.The information may be of the form of a note or comment describing thecondition or other relevant information of an object belonging to thedata set. The system may store that information and display it tocommunicate that the information belongs to the data set objectinitially associated with the note or comment. The information may alsobelong to the data set as a whole, representing a ‘general’ comment onthe data set or patient. This may include an allergy or other medicalcondition, the state of the patient's dentition, or other relevantaspect of the patient, such as oral hygiene or compliance withprocedures given previously (such as wearing elastics consistently). Thesystem may store any additional information with the inputtedinformation, such as the date or the user who inputted the information.The form of the note or comments appended to the objects may also takethe form of predefined statements, representing common procedures takenby a dental or medical practice, such that they may be selected as aparameter without the requirement to describe the procedure each time itneeds to be appended to the data set. These predefined statements may bemodified by the user to fit the needs of the practice in question.

In some examples, the parametric modeling described herein can beapplied to other medical fields involving modeling and/or charting suchas, for example, orthopedics, ophthalmology, cardiology, dermatology, orpodiatry.

While the foregoing invention has been described in some detail forpurposes of clarity and understanding, it will be appreciated by thoseskilled in the relevant arts, once they have been made familiar withthis disclosure, that various changes in form and detail can be madewithout departing from the scope of the invention. The invention istherefore not to be limited to the exact components or details ofmethodology or construction set forth above. Except to the extentnecessary or inherent in the processes themselves, no particular orderto steps or stages of methods or processes described in this disclosure,including the Figures, is intended or implied. In many cases the orderof process steps may be varied without changing the purpose, effect orimport of the methods described.

The invention claimed is:
 1. An electronic device for charting medicalinformation, the device comprising: at least one memory; and at leastone processor configured to: generate or retrieve a medical data setrepresenting at least a portion of an anatomical structure, the medicaldata set including: a set of base parameters including objectidentifiers and base values, each object identifier identifying athree-dimensional (3D) model visually representing an anatomicalcomponent or implement, the base values defining default positions andorientations of each of the 3D models relative to a base anatomicalmodel, and a set of modifiers defining changes to visual aspects of oneor more of the 3D models relative to the base values; generate a 3Drepresentation of at least the portion of the anatomical structure witheach 3D model positioned relative to each other in the 3D representationbased on the base values as modified by the modifiers; display the 3Drepresentation; receive an input based on an interaction with the 3Drepresentation; adjust at least one of the modifiers based on thereceived input; and store the medical data set including the at leastone adjusted modifier in the at least one memory.
 2. The device of claim1, wherein the modifiers include positional and orientational offsets ofeach of the 3D models relative to the base values.
 3. The device ofclaim 1, wherein retrieving the medical data set comprises retrievingone of a plurality of template medical data sets for creating a newmedical data set, each of the plurality of template dental data setsincluding a different predefined set of object identifiers and basevalues.
 4. The device of claim 1, wherein the medical data set includesbase values identifying a position and orientation of each 3D modelrelative to a position in a geometric arrangement defining theanatomical structure; wherein the 3D representation is generated witheach 3D model positioned relative to the geometric arrangement based onthe base values as modified by the modifiers.
 5. The device of claim 4,wherein the medical data set represents at least a portion of adentition, and includes the base values identifying the position andorientation of each 3D model relative to a position on a 3D curvedefining a shape of a dental arch.
 6. The device of claim 5, wherein themedical data set includes modifiers for modifying the shape of thedental arch; and wherein the 3D representation is generated with eachbase 3D model positioned relative to the shape of the dental arch asmodified by the modifiers.
 7. The device of claim 4, wherein the medicaldata set includes modifiers for modifying a shape of the geometricarrangement; and wherein the 3D representation is generated with eachbase 3D model positioned relative to the shape of the geometricarrangement as modified by the modifiers.
 8. The device of claim 4,wherein the at least one processor is configured to receive an input tospace out anatomical components in the geometric arrangement, or aninput to adjust the geometric arrangement by actuating the anatomicalstructure; update parameters associated with component spacing in thegeometric arrangement or parameters associated with adjusting thegeometric arrangement by actuating the anatomical structure; andgenerate an updated 3D representation with each 3D model positionedrelative to each other in the 3D representation based on the base valuesas modified by the updated parameters.
 9. The device of claim 8, whereinthe medical data set represents at least a portion of a dentition; andwherein the receiving input is an input to unfold at least one dentalarch, an input to space out dental arches, an input to open or close amouth, or an input to space out teeth in at least one dental arch. 10.The device of claim 1, wherein adjusting the at least one of themodifiers comprises: adjusting at least one modifier value to change atleast one of a size, a position and an orientation of a first anatomicalcomponent, the first anatomical component adjacent to a secondanatomical component in the anatomical structure; determining whether afirst 3D model associated with the first anatomical component asadjusted by the at least one modifier value collides with a second 3Dmodel associated with the second anatomical component as modified by atleast one modifier value associated with the second anatomicalcomponent; and restricting the change to the at least one of the size,the position and the orientation of the first anatomical component basedthe determination.
 11. The device of claim 10, wherein the medical dataset represents at least a portion of a dentition, and wherein adjustingthe position or the orientation of the first anatomical componentcomprises translating or rotating the first anatomical component alongat least one of: a mesial-distal axis, an apical-coronal axis, abuccal-lingual axis, and a curve of an arch.
 12. The device of claim 1,wherein adjusting the at least one of the modifiers comprises creatingor adjusting one or more parameters associated with a medical condition,medical activity or medical appliance; and wherein displaying the 3Drepresentation comprises displaying representations of the medicalcondition, the medical activity or the medical appliance on one or moreanatomical components based on the one or more parameters.
 13. Thedevice of claim 1, wherein the medical data set represents at least aportion of a dentition, and includes periodontal parameters.
 14. Thedevice of claim 1, wherein the medical data set represents at least aportion of a dentition, and wherein the displayed 3D representationincludes malocclusions based on the parameters of the medical data set.15. The device of claim 1, wherein at least one 3D model in the 3Drepresentation includes at least one marker associated with the at leastone 3D model, the at least one marker for: positioning the at least one3D model relative to one or more other 3D models, connecting the atleast one 3D model to one or more other 3D models, or providing a visualindication of the at least one 3D model.
 16. The device of claim 1,wherein the at least one processor is configured to display an updated3D representation upon each adjustment of the at least one of themodifiers.
 17. The device of claim 1, wherein the at least one processoris configured to receive a view-change input; and generate an updated 3Drepresentation having a different view based on the view-change input.18. The device of claim 1, wherein storing the medical data set includesmaintaining historical data for tracking changes to the anatomicalstructure over time.
 19. The device of claim 1, wherein the at least oneprocessor is configured to store the medical data set separately from 3Dmodels of anatomical components or implements; and wherein the 3Drepresentation can be re-generated with only the stored set of baseparameters and modifiers.
 20. The device of claim 1, wherein the atleast one processor is configured to generate signals for outputting ahuman-readable medical chart based on at least one of the medical dataset and the 3D representation, wherein generating the signals foroutputting the human-readable medical chart comprises condensinginformation from at least one of the medical data set and the 3Drepresentation.
 21. The device of claim 1, wherein the at least oneprocessor is configured to receive, via the 3D representation, asequence of selections at positions on the 3D models, the sequence ofselections indicating an order in which an connection object is to beconnected to the anatomical components or implements.
 22. The device ofclaim 21, wherein the medical data set represents at least a portion ofa dentition, and wherein the connection object is an elastic or wire.23. The device of claim 22, wherein the 3D representation includes avisual representation of at least one of an elastic and a wire inaccordance with the sequence of selections.
 24. The device of claim 23,wherein when a view-change input is received, and the 3D representationincludes at least one elastic, the visual representation of the at leastone elastic is redisplayed between new positions of the 3D models tosimulate stretching of the at least one elastic.
 25. The device of claim1 wherein the medical data set represents at least a portion of adentition, and wherein adjusting at least one of the modifierscomprises: adjusting at least one modifier defining a bend on a wireobject, the at least one modifier defining the bend comprising at leastone of: a bend location value, a value defining a translative effect ofthe bend, and a value identifying at least one tooth or applianceaffected by the bend.
 26. The device of claim 1, wherein the at leastone processor is configured to: retrieve a historical medical data set;and regenerate a 3D representation of at least the portion of theanatomical structure at an earlier time including at least portions ofthe D models positioned in the 3D representation based on the basevalues and modifiers of the historical medical data set.
 27. A methodfor charting medical information, the method comprising: generating orretrieving a medical data set representing at least a portion of ananatomical structure, the medical data set including: a set of baseparameters including object identifiers and base values, each objectidentifier identifying a three-dimensional (3D) model visuallyrepresenting an anatomical component or implement, the base valuesdefining default positions and orientations of each of the 3D modelsrelative to a base anatomical model, and a set of modifiers definingchanges to visual aspects of one or more of the 3D models relative tothe base values; generating a 3D representation of at least the portionof the anatomical structure with each 3D model positioned relative toeach other in the 3D representation based on the base values as modifiedby the modifiers; displaying the 3D representation; receiving an inputbased on an interaction with the 3D representation; adjusting at leastone of the modifiers based on the received input; and storing themedical data set including the at least one adjusted modifier in atleast one memory.
 28. The method of claim 27, wherein the modifiersinclude positional and orientational offsets of each of the 3D modelsrelative to the base values.
 29. The method of claim 27, whereinretrieving the medical data set comprises retrieving one of a pluralityof template medical data sets for creating a new medical data set, eachof the plurality of template dental data sets including a differentpredefined set of object identifiers and base values.
 30. The method ofclaim 27, wherein the medical data set includes base values identifyinga position and orientation of each 3D model relative to a position in ageometric arrangement defining the anatomical structure; wherein the 3Drepresentation is generated with each 3D model positioned relative tothe geometric arrangement based on the base values as modified by themodifiers.
 31. The method of claim 30, wherein the medical data setincludes modifiers for modifying a shape of the geometric arrangement;and wherein the 3D representation is generated with each base 3D modelpositioned relative to the shape of the geometric arrangement asmodified by the modifiers.
 32. The method of claim 31, comprisingreceiving an input to space out anatomical components in the geometricarrangement, or an input to adjust the geometric arrangement byactuating the anatomical structure; updating parameters associated withcomponent spacing in the geometric arrangement or parameters associatedwith adjusting the geometric arrangement by actuating the anatomicalstructure; and generating an updated 3D representation with each 3Dmodel positioned relative to each other in the 3D representation basedon the base values as modified by the updated parameters.
 33. The methodof claim 27, wherein adjusting the at least one of the modifierscomprises: adjusting at least one modifier value to change at least oneof a size, a position and an orientation of a first anatomicalcomponent, the first anatomical component adjacent to a secondanatomical component in the anatomical structure; determining whether afirst 3D model associated with the first anatomical component asadjusted by the at least one modifier value collides with a second 3Dmodel associated with the second anatomical component as modified by atleast one modifier value associated with the second anatomicalcomponent; and restricting the change to the at least one of the size,the position and the orientation of the first anatomical component basedthe determination.
 34. The method of claim 27, wherein adjusting the atleast one of the modifiers comprises creating or adjusting one or moreparameters associated with a medical condition, medical activity ormedical appliance; and wherein displaying the 3D representationcomprises displaying representations of the medical condition, themedical activity or the medical appliance on one or more anatomicalcomponents based on the one or more parameters.
 35. The method of claim27, wherein at least one 3D model in the 3D representation includes atleast one marker associated with the at least one 3D model, the at leastone marker for: positioning the at least one 3D model relative to one ormore other 3D models, connecting the at least one 3D model to one ormore other 3D models, or providing a visual indication of the at leastone 3D model.
 36. The method of claim 27, comprising displaying anupdated 3D representation upon each adjustment of the at least one ofthe modifiers.
 37. The method of claim 27, comprising receiving aview-change input; and generating an updated 3D representation having adifferent view based on the view-change input.
 38. The method of claim27 wherein storing the medical data set includes maintaining historicaldata for tracking changes to the anatomical structure over time.
 39. Themethod of claim 27 wherein the at least one processor is configured tostore the medical data set separately from 3D models of anatomicalcomponents or implements; and wherein the 3D representation can bere-generated with only the stored set of base parameters and modifiers.40. The method of claim 27 comprising generating signals for outputtinga human-readable medical chart based on at least one of the medical dataset and the 3D representation, wherein generating the signals foroutputting the human-readable medical chart comprises condensinginformation from at least one of the medical data set and the 3Drepresentation.
 41. The method of claim 27 comprising receiving, via the3D representation, a sequence of selections at positions on the 3Dmodels, the sequence of selections indicating an order in which anconnection object is to be connected to the anatomical components orimplements.
 42. The method of claim 27 comprising: retrieving ahistorical medical data set; and regenerating a 3D representation of atleast the portion of the anatomical structure at an earlier timeincluding at least portions of the D models positioned in the 3Drepresentation based on the base values and modifiers of the historicalmedical data set.
 43. A non-transitory, computer-readable medium ormedia having stored thereon computer-readable instructions which whenexecuted by at least one processor configure the at least one processorto: generate or retrieve a medical data set representing at least aportion of an anatomical structure, the medical data set including: aset of base parameters including object identifiers and base values,each object identifier identifying a three-dimensional (3D) modelvisually representing an anatomical component or implement, the basevalues defining default positions and orientations of each of the 3Dmodels relative to a base anatomical model, and a set of modifiersdefining changes to visual aspects of one or more of the 3D modelsrelative to the base values; generate a 3D representation of at leastthe portion of the anatomical structure with each 3D model positionedrelative to each other in the 3D representation based on the base valuesas modified by the modifiers; display the 3D representation; receive aninput based on an interaction with the 3D representation; adjust atleast one of the modifiers based on the received input; and store themedical data set including the at least one adjusted modifier in the atleast one memory.